This competency model for Lead Case Managers utilizing Integrated Case
Management reflects the insight, contributions, and labor of many people.
We would like to express appreciation to the following individuals whose
assistance has been invaluable:

The numerous case managers at the Integrated Case Management pilot sites
who reviewed, edited, and revised many drafts.

Institute staff involved in this project include:

Freda Bernotavicz,
who directed the development of the competency model.Melinda
Brubaker, who developed the first draft of the competency model.Polly
Campbell, who provided support and insight from the cross-disciplinary
training project.RuthAnne
Spence, who developed and integrated the cross-systems and technical
knowledge competencies into existing Institute for Public Sector Innovation
published competencies.Phyllis
vonHerrlich, who provided support to the process and directed the final
report production.Karen
Wood, who provided editorial assistance.

Support for the publication of these competencies was provided through
a Child Welfare Training Grant from the Administration for Children, Youth,
and Families, U. S. Department of Health and Human Services (Grant # 90-CT-0001).

In the fall of 1997, the Institute for Public Sector Innovation at the
University of Southern Maine's Edmund S. Muskie School of Public Service,
in collaboration with the Maine Children's Cabinet, began work on an Interdisciplinary
Training Program funded by the DHHS Children's Bureau. The goal of the
project was to develop improved outcomes for children and families (especially
in instances of child abuse and neglect complicated by substance abuse,
mental illness and domestic violence) through interdisciplinary case management
and integrated service delivery.

Central to this effort was the development of a competency model for the
role of Lead or Primary Case Managers utilizing an Integrated Case Management
(ICM) system to coordinate and provide services to children and families
in Maine. The competency model lays the foundation for case managers,
from any of the range of disciplines, to enhance their professional case
management and group facilitation skills.

This report summarizes the work of developing the competency model and
includes a description of the Integrated Case Management initiatives,
the procedures for developing the competency model, and the model itself.

These materials are the result of a lengthy collaborative process among
public agencies, the ICM pilot project communities, and the state university
system. Each of the partners in this process brings their own perspective
and knowledge base as we pursue the common goal of improving the welfare
of children and families in Maine. The competency model produced through
this process is a living document, a work in progress that we continue
to refine and adapt. In presenting this product to the field, our hope
is that others throughout the country involved in similar cross-systems
work will benefit from our experience as they strive together to produce
relevant materials for their own use.

Freda Bernotavicz
Augusta, Maine
2000I.
Introduction

A. The Need
for Systems Change

Senge uses this story to illustrate the importance of getting to the root
of problems in systems thinking. It can be applied equally to the concept
of systems change. Over the years, we have tended to throw rugs over the
problems involved with providing services to children and families. Different
people, from different disciplines, each with their own approach... one
rug on top of the other ... each masking for a time the underlying issues.
These layers of rugs are one of the reasons why systems change work is
so hard. To really get to the root of the problem, we have to peel back
the rugs, one at a time, the way the rug dealers do. As we get further
and further down the pile, closer to the ground level, the work becomes
harder as the weight of the rugs increases. And what do we find there
underneath the many layers, what snakes and spiders, cracks and pockmarks,
uneven flooring and warped planks? And yet, to truly address the problems,
we need to engage in this tedious, strenuous and challenging work. Moxley
(1989) suggests that one way to address the problem of fragmented services
is through increased collaboration and case management.

In 1995 Governor Angus King established the Children's Cabinet in response
to identified problems with the fragmented delivery of services to Maine's
children. The Children's Cabinet includes the Commissioners of the Departments
of Corrections, Education, Human Services, Mental Health, Mental Retardation
and Substance Abuse Services, and Public Safety. In his charge to the
Cabinet, the Governor emphasized the Commissioners' important leadership
role to collaborate and promote the concept of a seamless service delivery
system for children and families, as well as the need to pool funding
to maximize limited resources.

Recognizing the complexities faced by today's families, especially those
with multiple needs, when attempting to access social services, the Children's
Cabinet of Maine established the Integrated Case Management (ICM) initiative
in 1997. The vision behind this initiative is to:

provide
Maine families and children with access to services that are planned
for, managed and delivered in a holistic and integrated manner in order
to improve their self-sufficiency, safety, economic stability, health
and quality of life.

The goals of the Integrated Case Management initiative are:

to integrate
case management business practices across departmental lines to create
a fully coordinated and seamless delivery system, and

to create
a "federated system" using an integrated case management system
that is electronically linked.

Rather than a system that delivers services categorically by individual
agencies, resulting in costly fragmentation and services that are often
unavailable to those most in need, Integrated Case Management represents
a fundamental reform in the way services are delivered. Under this initiative,
agencies have joined for the purpose of improving services. Additionally,
ICM policy committees actively participating in this project are building
collaborative processes into their design and development work and have
begun to build them into their service delivery systems.

C. The Role of the Lead Case Manager

One of the fundamental tenets of the Integrated Case Management initiative
is that when a family is being served by two or more case managers, one
case manager becomes the Lead Case Manager to orchestrate the Integrated
Case Management process. The role of the Lead Case Manager is to take
a holistic view of the family, its service providers, and its familial
and community support systems. The Lead Case Manager engages with the
family to identify all pertinent information, services, and existing case
plans necessary to coordinate an ICM team meeting at which a comprehensive
case plan for the whole family can be developed. Respectful of any safety
or statutory parameters that may exist, the Lead Case Manager is responsible
for convening the initial ICM meeting where, based on the family's specific
issues and the constellation of ICM team players, a comprehensive family
plan, along with an individualized ICM process to guide implementation
of that plan, is developed.

Implementation of the family plan is supported and guided by the Lead
Case Manager and reflects the commitment of all team members to the distribution
of tasks and responsibilities, the movement toward desired outcomes, and
establishment of accountability. Thus, the Lead Case Manager's role in
ICM incorporates both the generalist case management functions of monitoring
and supporting the family with implementation of their plan and the more
extensive cross-systems case management functions such as resolving conflicts,
breaking down barriers, and coordinating various plan adjustments with
the multiple service and support systems identified in a family's plan.

D. Interdisciplinary Approaches

Despite the fact that professionals from different fields are often working
with the same families, they generally function in isolation from each
other. The separation of the disciplines results in duplication of efforts,
clients "falling through the cracks", miscommunication among
providers and clients, professional parochialism and contradictory treatment
approaches. This lack of coordination, communication and collaboration
is counterproductive to effective delivery of services to affected children
and families, and families are often confused and overwhelmed by the fragmented
service delivery system.

Behaviors that diminish collaboration and maximize delays and problems
with providing responsive services to children and families include:

a focus
on one's own disciplinary mandates and constraints;

a lack of
familiarity with the mandates, philosophy and constraints of other disciplines;

an emphasis
on protecting one's disciplinary "turf";

an orientation
to a discipline rather than to the client/family; and

a desire
to make the family fit with the discipline's framework rather than adapting
the discipline to the family's need.

Each disciplinary perspective is a view of the world, a mental model,
that can obscure what is truly there. Four major factors appear to be
critical to the success of interdisciplinary approaches: shared vision,
family-centered, experiential and competency-based.

Shared vision: Interdisciplinary efforts need a guiding vision
for improving outcomes for children, youth and families. Absent such a
vision, collaboration and integration tend to be pursued as ends or goals
in themselves (Lawson and Hooper-Briar, 1994). The Maine Children's Cabinet
began its work in 1994 with the articulation of a clear vision, including
the need for state agencies to collaboratively support families and communities,
by keeping children and families at the heart of all decisions. This vision
has informed the Integrated Case Management process and related training.

Family-centered: To make the transition from categorical thinking,
providers need to embrace a relational view, which means that children
and youth cannot be served or understood without considering the characteristics
and capacities of their families. Understanding and supporting the family
are impossible without referencing the community (Lawson and Hooper-Briar,
1994). Thus, Maine's Integrated Case Management approach considers the
entire family as the "case" in line with the Children's Cabinet
vision that children's needs are best met within the context of relationships
at the family and community levels.

Competency-based: Clearly, it is not possible to expect all professionals
from all disciplines to have the in-depth knowledge of each separate discipline.
On the other hand, to collaborate effectively more knowledge is needed
than simply the skills of collaboration (e.g. consensus building, compromise
tactics, barrier-busting strategies and conflict resolution approaches).
The right balance can be found through a competency-based approach (Bernotavicz,
1994), which allows the following:

clear delineation
of the competencies which include the functional (specific content)
knowledge and skills of each discipline; the interpersonal skills to
function collaboratively; and contextual knowledge and skills (systems
or task environment knowledge, including the mandates and service constraints
and ways of dealing with them);

self-assessment
in relationship to the competencies;

ability
to access other training to complement the core training.

Experiential: Practitioners learn best by doing. To effect the
fundamental changes in knowledge, attitudes and behavior necessary to
promote systems change, training must be designed so that close connections
are made between conceptual and experiential learning (Knapp et al., 1993).
In addition, opportunities for self-directed, continuous learning are
needed so that practitioners are encouraged to continue learning beyond
their core training. Since group-based problem solving and learning strategies
are at the heart of successful collaborations, they must be emphasized
in training and in experiential workplace learning through successful
innovative approaches such as peer training, reflective practice, and
guided case reviews.

E. A Holistic Approach to Competencies

The Institute for Public Sector Innovation (IPSI) supports training that
is based on a holistic view of the competencies needed for effective performance
on the job. This holistic view includes both the specific job tasks, the
individual performing the job and the organizational context.

Tasks: Jobs are more than a sum of the specific job tasks. Jobs
are not static. Particularly in today's volatile work environment, they
are made up of a variety of responsibilities that change in response to
emerging needs of the organization. People do not perform tasks in a neat
sequence, one at a time. In the real world, people juggle several tasks
at once, shifting gears and setting priorities in media res. Thus, anticipating
new priorities, collaborating with others, and managing the workload are
all essential job functions in addition to the specific tasks that form
the core responsibilities for any job. The mechanistic view of jobs, as
a listing of job duties that can be defined in a job description, is being
replaced by a more organic view of jobs as a fluid set of responsibilities.

Further, new organizational patterns are promoting the concept of inclusion
and participation, recognizing that to be effective an organization needs
input from all levels. As we move towards these new organizational structures,
the concept of people performing specific tasks in isolation becomes less
relevant. The concept of "contextual performance" recognizes
that effective organizations need people who commit significant time and
effort to extra-job activities such as volunteering on committees, mentoring
new employees, and supporting the organization's goals.

Individual: People at work are whole persons. We can think of individuals
at work as being like icebergs. Above the surface, we can observe the
knowledge, skills, and abilities (often called the KSAs) needed to perform
the job tasks. However, below the surface are a number of personal characteristics
(their attitudes, values, traits, and motives) that influence how well
they do their job as a whole. This entire range of KSAs and personal characteristics
make up the competencies needed for effective performance.

Studies have shown that the competencies that distinguish outstanding
performers tend to be the underlying personal characteristics such as
flexibility or results orientation rather than KSAs such as interviewing
skills or the ability to operate a particular piece of equipment. Because
the underlying personal characteristics are more difficult to change,
it makes sense to screen and hire for individuals with the necessary underlying
personal characteristics and train for the KSAs once people are on the
job.

Context: Jobs are not performed in a vacuum but in specific organizational
settings. The mission and goals of the organization, its customers or
clients, policies, procedures, structure, culture and climate all impact
on how the job is defined and what constitutes effective job performance.
Therefore, a holistic view of competencies also includes the contextual
knowledge and skills needed to be effective in a specific organization.

Some of these contextual knowledge and skills are readily acquired in
an orientation program. For example, the specific policies and procedures
of the organization, the standard operating procedures (SOPs), the specific
software program or information system, the organizational structure and
reporting relationship are all appropriate content for on-the-job training.
Other contextual skills are less easy to acquire on the job. For example,
the culture of an organization may require a degree of conformity and
deference to authority that an otherwise qualified individual may not
be able to demonstrate. In these instances, it is appropriate to identify
the necessary contextual skills and to screen for them in the hiring process.

A systems view of job performance suggests a continual, dynamic interaction
among these three major components: the tasks or job duties, the individual
performing the job, and the organizational setting or context. A holistic
view of competencies includes all three components: first, the KSAs that
are needed to perform the tasks; second, the underlying personal characteristics
that distinguish effective performers (the attitudes, values, traits and
motives which drive people to action); and third, the context skills and
knowledge needed in the specific organizational setting. Finally, linking
all these skills (as a meta-competency), the IPSI competency model emphasizes
self-awareness and reflective practice as the basis for self-directed,
ongoing learning to bridge the gap from the classroom to job performance
in the real world of work.

F. Developing of A Holistic Competency Model

Developing a holistic competency model requires combining several different
approaches to the analysis of job performance and to the collection of
data.

Knowledge, Skills and Abilities (KSAs): The functional or task-related
knowledge and skills are developed through task analysis using both on-site
observation and expert opinion. Here the focus is on generating detailed
listings of the job duties and then identifying what people need to know,
or to be able to do, in order to perform these tasks. People familiar
with the job (incumbents, supervisors or trainers), the so-called Subject
Matter Experts (SMEs) are used to identify this information.

Personal Characteristics: The characteristics of outstanding performers
are generated through a different technique known as the Behavioral Event
Interview. Using a structured approach, trained interviewers probe beneath
the surface to articulate the underlying characteristics of individuals
who have been identified as being outstanding at their particular job.

Context Knowledge and Skills: The identification of the context
knowledge and skills requires yet another approach. Here the unit of analysis
moves from the specific job tasks to the organizational setting. Some
of this information is drawn from organizational data in policy and procedures
manuals. Surveys or focus groups provide more in-depth information on
the organizational culture and climate.

This holistic approach to competency identification results in a competency
model which has five categories:

(1) Work
Management Skills: Performing effectively in the work context.

Each category contains a list of competencies with specific behavioral
indicators that demonstrate optimal performance.

Data from each of the different approaches are combined and redundancies
eliminated. The resulting model is then reviewed and validated by focus
groups familiar with the job in question. Such reviews ensure that both
concepts and language accurately reflect the experience of those most
knowledgeable about effective performance. Furthermore, the reviews reflect
the Institute's commitment to shared ownership.

In this holistic approach, effectiveness on the job is viewed as a process,
a constant spiral of learning, growth and renewal which stems from the
individual's inner core of competencies, her or his attitudes, values
and motives. Because training can address this inner core only to a limited
extent, the responsibility for the on-going process of effectiveness must
rest with each individual.

A holistic approach also recognizes that effective functioning in the
real world of work involves the capacity to learn from experience and
to manage change. The truly competent professional is engaged in an ongoing
process of self-assessment and reflective practice, competencies that
are emphasized throughout the training offered by the Institute as well
as modeled by the trainers. In this constant spiral of learning and growth,
of reflecting upon and learning from experience, the individual is engaged
in a continual process of becoming competent at being competent.

II.
Development of A Competency Model for Integrated Case Management Lead
Case Managers

A. Approach

Developing a competency model for the Lead Case Manager role was challenging
for a number of reasons:

Role not a job: unlike other competency models developed by the
lead author (e.g. child welfare case workers and supervisors, child support
enforcement agents, adoptive and foster parents, child care teachers),
the Lead Case Manager is not a job, but a role which can be played intermittently
by different individuals.

Role not defined: when the competency model was first developed,
the Integrated Case Management initiative was in its preliminary planning
phase. The Steering Committee decided to implement pilot programs in three
areas of the states and to leave decisions about functions, processes
and roles to each of the pilot sites. As a result, it was difficult to
ascertain the responsibilities of the Lead Case Manager. In fact, the
role is different in the two pilot sites where the ICM was implemented.
In one site, the Coordinator role and Facilitator role are separated and
carried out by two different individuals.

Interdisciplinary issues: since the selection of the Lead Case
Manager is made in concert with the family, the person assuming the role
may be from one of many different disciplines: a mental health specialist,
domestic violence advocate, child welfare caseworker, a housing specialist,
adult literacy teacher, etc.

Because of these issues, a research-based approach (combining task analysis,
behavioral event interviews and organizational assessment) was not appropriate
in developing the competency model for Integrated Case Management Lead
Case Managers. Instead, the approach recommended by Spenser and Spenser
(1993) for developing competency models for jobs not yet performed was
utilized, i.e. extrapolation from job elements and competency correlates
of known jobs. Other research-based competency models were utilized as
a starting point, primarily the "Maine Competency Model for Child
Welfare Caseworkers" (1994) and the "Maine Competency Model
for Child Welfare Supervisors" (1996). These models formed the basis
for the competencies in the areas of Work Management, Interpersonal, Conceptual,
Self-Management and Case Management Technical Knowledge and for the Child
Welfare specific technical knowledge.

In utilizing existing data to develop the model, a basic assumption about
the role of Lead Case Managers was made. Since the ICM model framework
requires that two or more case managers be involved with a family in order
to provide ICM services, and that the Lead Case Manager would be identified
from the existing group of case managers working with the family, it is
assumed that in order to be a Lead Case Manager, those selected would
already possess general case manager competencies as their basis. Therefore,
the Lead Case Manager competencies incorporate both generalist case management
skills/behaviors as well as the interdisciplinary cross-systems case management
skills/behavior needed for ICM. For example, the additional need for the
collaboration skills and behaviors necessary to negotiate across departments,
agencies, and systems moves beyond the more generalist coordination skills
all case managers need to have.

Context skills identify the competencies required to function effectively
in a specific organizational setting. To complete the picture of the competencies
needed for effective performance in the provision of Integrated Case Management
services, information about cross-systems context and interdisciplinary
team settings was needed. Insights on competencies relevant to interdisciplinary
work were drawn from the curriculum "Caring for the Abuse Affected
Child Cross-Disciplinary Training Manual" (Devoe, et al., 1993, 1996
Revision). Drawing on the Institute's five-year history of providing such
training, a group of cross-disciplinary trainers and trainees were surveyed
to identify the key contextual components of successful collaborative
cross-systems teamwork. Analysis of their responses produced a list of
context skills (e.g. negotiation of competing mandates and/or needs within
a specific service plan for a family) that was incorporated into the competency
model in the categories of work-management, interpersonal, and technical
knowledge/skills.

The challenge for the ICM training workgroup was to review this voluminous
source of information, eliminate redundancies, and synthesize the various
job and disciplinary information in order to identify those core competencies
and behavioral indicators relevant to the provision of interdisciplinary
case management.

B. Review and Verification

Once the competency model had been developed, content experts and service
providers from each of the four disciplines (domestic violence, child
welfare, substance abuse, and mental health) reviewed and revised the
entire listing. These reviews resulted in changing the language to make
it more reflective of the target audience, and in building familiarity
and ownership of the competencies. The discipline-specific categories
for the Technical Knowledge/Skills were refined considerably as a result
of this process.

The draft competency model was further reviewed and refined by ICM training
subcommittee members, disciplinary content experts, and pilot site ICM
team case managers and participants. Through this review and revision
process, various competencies and behavioral indicators were solidified
as central to the job of ICM Lead Case Manager, understanding that the
specific context will be different based on the composition of the team.
The final listing of 23 lead case manager competencies and the companion
25 discipline-specific competencies are a blending of both historic and
current best practice competency-based case management.

Because ICM Case Management is a "new" model being piloted,
we did not have a cadre of "outstanding performers" with whom
to do behavioral event interviews. Thus, we cannot know yet whether or
not this competency model truly captures the characteristics of outstanding
performers.

C. Applications

Competency models can be utilized for a number of performance management
applications including the following:

In the current Maine Integrated Case Management system, the role of the
Lead Case Manager is situation-specific and the selection of the individual
to assume the responsibility for the role is based on family preference
rather than competency. However, as the Initiative becomes institutionalized,
a certification process is envisioned. The competency model can then provide
the framework for the following:

Selection: designing assessment protocols to select individuals
to participate in the certification program.

Designing curriculum: identifying competencies to be addressed
in the training interventions linked to the certification process.

Quality assurance: communicating about performance issues; providing
feedback to Lead Case Managers during or following an assignment to a
case; reflecting upon successes or failures in a case intervention; resolving
problems in the case management team.

As mentioned in the preface to this report, the competency model is a
work in progress. It is designed to help state and local communities think
about what it takes to do the work in which they are engaged day-to-day,
and to do it collaboratively. Provision of integrated case management
services moves beyond the coordination of services initiated over the
past decade. True integration requires a cultural change in the way we
work with both families and the multiple systems affecting their lives.
Transformation at this scale is difficult, time consuming, and ever evolving.
As this ICM Lead Case Manager model is reexamined, rearranged, and applied
in new and different ways, it can become increasingly meaningful and useful
to cross-systems and inter-disciplinary case management professionals.
Hopefully, it will continually provide feedback for the improved and expanded
practice of cross-disciplinary case management.

Peeling back the layers of rugs to reveal the foundation of the problems
faced by children and families is work that demands patience, perseverance,
resilience and a willingness to work together across the various disciplines
involved. Using a competency-based approach is one way to help communicate
about and focus this important work.

08.03 Questioning Techniques: Uses a variety of questioning techniques
to elicit information needed to form conclusions and/or make decisions.

08.04 Ensures Information is Comprehensive and Clear: Makes sure clients/families
have all the available information needed to manage situations and make
sound decisions; explains complexities in an easy-to-understand manner.

14.05 Patience: Demonstrates patience and acceptance; gives people reasonable
time to understand or to change.

15.00 Self-Confidence

15.01 Optimism and Trust in Self: Believes in own decisions; and is
optimistic about own ability to get the job done.

15.02 Decisive Action: Is able to think on one's feet and to be decisive
in ambiguous or chaotic situations.

15.03 Assertiveness: Knows when to be assertive, when to take a strong
stand on issues, when to confront others.

16.00 Flexibility

16.01 Fairness:
Recognizes the pros and cons of alternative views.

16.02 Adaptability: Adapts personal and professional styles to meet
the needs of specific situations or clients and families.

16.03 Open to Change: Is open to new information and changing own opinion.

16.04 Redirective: Is able to shift gears and redirect activities.

16.05 Acknowledges Case Outcomes: Acknowledges and copes with both positive
and negative outcomes of cases; recognizes and deals with issues of
grief and loss, including lost opportunities and perceived error.

V. Case Management Technical Knowledge/Skills:

17.00 Statutory and Regulatory Bases

17.01 Statutory
and Regulatory base: Understands the basis in federal and state law,
regulations and rules for the operation of social service programs.

17.02 Knowledge of Relevant Statutes: Knows the specific statutes related
to the disciplines involved in the case, and their interrelationship
with other related laws.

17.03 Terminology, Definitions and Concepts: understands the legal terminology,
definitions and concepts of the disciplines involved in the case.

17.04 Legal System: Understands jurisdictions of various courts that
deal with children and families.

18.00 Policies and Procedures

18.01 Policy
Base: Understands the basis in policy for the operation of social service
programs.

18.02 Policy and Procedures: Knows the specific policies and procedures
related to the social service programs and their interrelationship with
each other.

18.03 Terminology, Definitions and Concepts: Understands policy terminology,
definitions and concepts and is able to apply them appropriately to
case management.

18.04 Ethical Issues: Understands the policy requirements of ethical
practice and the ramifications to staff and clients when this does not
occur.

19.02 Involves Key Players: Identifies key players in a family's life
and configures the interdisciplinary and community team.

19.03 Individualized: Assesses client/family to identify needs that
are unique to each individual/family and develops plans that are as
"normal" as possible, culturally sensitive and specific to
each case.

19.04 Strengths-based: Assures that family member strengths are identified
and ties strengths to actions when developing a case plan.

20.01 Case
Management Principles: Understands and is able to identify standards
for Integrated Case Management.

20.02 Case Planning Process: Understands and is able to identify standards
and procedures for prioritizing needs and objectives and for designing
clear, concise action/service plans that address outcomes, incorporate
measurable activities, and have meaning to the family.

20.03 Case Documentation: Understands and is able to identify standards
and procedures for identifying pertinent data for inclusion in case
records and reports; organizing information in a clear and concise manner;
writing summaries of assessment, case plan and other supporting data
for the case record in a timely manner.

20.04 Outcome Measures: Understands and is able to identify definition
and purposes of outcome measures.

20.05 Case Coordination: Understands and is able to utilize approaches
to coordinate
implementation of services, evaluate effectiveness of services to meet
desired outcomes and modify plan as necessary.

20.06 Case Reviews: Understands and is able to identify standards and
procedures for routine and timely reviews.

20.07 Service Contracts and Referrals: Understands and is able to identify
standards and techniques for coordinating the timely delivery of services
to meet identified needs, including identification of community resources,
advocacy, and appropriate follow-up reports.

20.08 Case Termination: Understands and is able to identify criteria
and procedures for effectively terminating a relationship with a family.

21.00 Cultural Sensitivity

21.01 Cross-Cultural
Diversity: Understands and is able to identify differences in cultural,
ethnic, and religious values, perceptions, customs and behaviors.

21.02 Cross-Cultural Interactions: Understands and is able to identify
ways cultural variables can impact on an assessment as well as ways
of communicating and establishing relationships with clients/families
from cultural backgrounds different from one's own.

22.02 Cost-effectiveness: Oversees case management operations (e.g.
workflow, timelines, the use of resources, costs and revenues) in order
to provide services in a cost-effective manner.

23.00 External Relationships

23.01 Community
Service Network: Understands the community service network and develops
relationships external to the team's disciplines.

23.02 Constituencies, Collaborators, and Competitors: Understands the
perspectives and interests of key constituencies, collaborators, and
competitors; works to build and maintain a positive public image with
constituents.

23.03 Respectful: Demonstrates a high level of respect for all constituencies.

23.04 Information Sharing: Provides information to the community and
others about the agencies and their programs and services.

23.05 Customer Service Orientation: Understands the overall service
system as well as relevant service approaches for populations of persons
served.

23.07 Stakeholder Collaboration: Works collaboratively with both formal
and informal groups of stakeholders such as Boards, Advisory Committees,
advocates, family members, and personnel.

C. Interdisciplinary Competencies

I. Child Welfare

1.00 Protection of Children

1.01 Definitions
of Abuse and Neglect: Understands definitions of child abuse and neglect
and corresponding levels and methods of interventions.

1.02 Dynamics and Indicators of Abuse and Neglect: Understands dynamics
and indicators of neglect and of physical, sexual and emotional abuse
including family violence and their traumatic impact on children and
families.

1.03 Reporting of Abuse and Neglect: Understands the statutory responsibility
for reporting suspected abuse and neglect.

1.04 Investigation: Understands and is able to describe specialized
methods to assess alleged abuse, neglect, or sexual abuse in foster
homes, day care homes, or child care institutions.

1.05 Intervention: Knows how to develop and implement plans and interventions
necessary for the protection of children and family members which may
include family (re)habilitation, preservation and/or (re)unification.

1.06 Treatment: Knows available treatment resources and modalities for
dealing with child abuse and neglect.

2.00 Services to Families

2.01 Family
Systems Theory and Therapy: Understands and is able to identify theoretical
frameworks and procedures for assessing family dynamics, understanding
their relationship to abuse and neglect, and intervening (including
family interviews and service referral).

2.03 Family Preservation: Understands and is able to identify standards
and casework methods to promote permanence for children, including parent
involvement in case planning, services to maintain children in their
own homes, parent involvement with children separated by placement,
and services for timely reunification.

3.00 Services to Children in Care

3.01 Effects
of Placement out of Family: Understands and is able to identify the
effects on children who have been removed from their families and have
been placed in another setting with different history, culture, values,
expectations and behavior.

3.03 Family Connectedness: Understands the dynamics of family relationships,
the disruption resulting in separation, and the importance of maintaining
a type of connectedness with previous families, based on an assessment
of each family's situation and the child's needs.

3.04 Placement Resources: Has knowledge of various types of placement
and their differential use based on the child's needs, has knowledge
of criteria for selecting among the alternatives (e.g., kinship care,
foster homes, specialized foster homes, group homes, residential treatment
centers), admission and agency approval procedures.

3.05 Preparation for Placement: Understands and is able to utilize knowledge
and techniques for preparation of the child and the child's placement
resource, the need for continuity and information for and about the
child, and ways to reduce stress and facilitate adjustment.

3.06 Special Education: Understands the broad criteria for identifying
children in need of special education services, the Pupil Evaluation
Team (PET) process, and the roles of the local education administration
(LEA), the surrogate parent and the caseworker as set forth in agency
policy.

3.07 Extended Care: Understands the criteria and procedures for voluntarily
extending care nearing adulthood and its relationship to developing
independent living skills and abilities.

3.08 Placement Supervision: Understands methods and techniques for working
collaboratively with foster parents and other caregivers to identify
issues, needs and risk factors in the particular placement and jointly
develop strategies to meet needs to access and coordinate resources.

3.09 Child Safety: Understands procedures for on going monitoring to
identify indicators of risk and procedures for appropriate intervention.

4.00 Human Development

4.01 Developmental
Process: Understands and is able to identify stages and processes of
attachment as well as physical, cognitive, social and psychological
development.

4.02 Sexual Development and Behavior: Understands and is able to identify
the process of human sexual development including sexual identity, sexual
orientation and behavior as well as related issues such as sex education,
birth control, teen pregnancy, gay, lesbian and bisexual youth, sexually
transmitted disease and abortion.

4.03 Developmental Challenges: Understands and is able to identify the
causes, symptoms and treatment approaches for developmental challenges
or conditions such as attachment disorder, attention deficit hyperactivity
disorder, fetal alcohol effect and syndrome, mental retardation, adolescent
depression, suicide and other emotional disturbances, cerebral palsy
and other conditions that delay or impair development.

5.00 Psychology

5.01 Separation
and Loss: Understands and is able to identify the stages of grief and
recovery related to separation or loss and the appropriate response
to each.

5.02 Stress: Understands and is able to identify the causes and effects
of stress and techniques for effective stress management and self-care.

5.03 Trauma and Victimization: Understands and is able to identify the
causes and effects of trauma and victimization including the impact
of early and cumulative trauma and victimization and techniques for
management and recovery.

5.04 Power and Control: Understands and is able to identify power and
control as forces that drive behavior, their use and abuse, and responses
to their abuse such as co-dependency, domestic violence, child abuse
and neglect.

5.05 Mental Dysfunction: Understands and is able to identify the types
of mental dysfunctions, their manifestations, implications and management.

5.06 Addiction Recovery: Understands and is able to identify stages
of recovery from addiction and effects of the recovery process on the
family system.

5.07 Psychological Testing and Evaluation: Understands and is able to
identify purposes of cognitive, emotional, social, and developmental
assessments; techniques for formulating specific referral questions,
evaluating the quality of the assessment, and using psychological information
in the development of the case plan.

6.02 Health and Medical Conditions: Understands the factors that can
effect the well-being of individuals and can identify symptoms or conditions
which indicate the need for health care or immediate medical attention.

6.03 Family Health History: Understands and can identify relevant factors
in family and personal medical and genetic history and applications.

6.04 Medical Tests: Knows the types, purposes of tests, including x-ray
techniques, blood tests, and cultures commonly used for diagnosis or
treatment.

6.05 Medications: Knows the types, purposes, and frequent side effects
of prescribed medications and knows how to secure such information when
necessary.

6.06 Legal and Policy Issues: Understands the legal and policy issues
related to particular diagnoses such as sexually transmitted diseases,
HIV-AIDS, and other communicable diseases, and knows how to secure appropriate
guidance for management of these issues.

6.07 Alcoholism and Drug Abuse: Understands and can identify the dynamics
and indicators of addiction, medical risks, impact on individuals and
families, the connection with family violence, methods of intervention
and treatment.

II. Domestic Violence

1.00 Dynamics of Domestic Violence

1.01 Historical
Perspective and Grassroots Philosophy: Understands the historical perspectives,
the grassroots philosophy, and the empowerment model approaches utilized
within the battered women's movement and that inform and direct domestic
violence work.

1.02 Cultural Norms and the Prevalence and Patterns of Occurrence: Understands
the cultural/societal context in which domestic violence occurs and
how it supports and reinforces violence and battering.

1.03 Definitions of Abuse, Battering, and the Continuum of Abuse: Understands
statutory definitions of abuse and assault, and the continuum of abuse
(Emotional/Psychological, Sexual Abuse, and Physical Abuse).

1.04 Myths and Perceptions: Understands how the dynamics of stereotyping,
myths, and preconceptions work to keep abuse personal and hidden rather
than public and connected to a larger political/societal picture.

1.05 Power and Control: Understands the Duluth Power and Control Wheel,
the Equality Wheel, and how the issues of power and control frame the
way domestic violence occurs.

1.07 Lesbian/Gay Battering: Understands dynamics of lesbian/gay battering,
the similarities and differences between heterosexual and lesbian/gay
battering, heterosexual privilege, and the Power and Control Wheel for
lesbians and gays.

1.08 Other Oppressions: Understands the connections and reinforcing
effects of other forms of oppressions (racism, classism, sizism, ageism,
ableism, etc.) with sexism, and how patriarchy, privilege, and violence
support continued oppression.

2.00 Effects of Domestic Violence on Children

2.01 Definitions
of Child Abuse and Neglect: Understands definitions of child abuse and
neglect, and the dynamics and impact of domestic violence and child
abuse/neglect for children and families.

2.02 Dynamics and Indicators of Abuse and Neglect: Understands dynamics
and indicators of neglect and of physical, sexual and emotional abuse
and their traumatic impact on children and families.

2.03 Reporting of Child Abuse and Neglect: Understands the statutory
responsibility for mandated reporting of suspected child abuse and neglect.

2.04 Effects of Violence on Developmental Stages: Understands and is
able to identify the effects violence has on the human growth and developmental
stages, and the commonalties between child abuse and woman abuse.

2.05 Children's Perspective, Understanding and Experience of Domestic
Violence: Understands and recognizes children's perspective and experiences
of violence, trauma, separation, and safety are different from the adult
experience, and recognizes the dynamics and impact of adult privilege.

2.06 Empowering Children and Advocacy for Children: Understands empowerment
of children and develops and utilizes supportive listening, crisis counseling
intervention, and advocacy skills when working with children who have
experienced domestic violence.

3.03 Effects of Sexual Violence and Response: Knows how to recognize
the effects of and responses to sexual violence, including the social
attitudes and functions of sexual assault, and can provide support and
appropriate interventions to the victim.

3.04 Effects of Incest and Response: Knows how to recognize the dynamics,
indicators, and effects of incest and can provide appropriate response
to the adult incest survivor.

3.05 Similarities of Survivors: Understands the commonalties of victims
of various forms of sexual abuse as well as the similarities and differences
for lesbian and gay victims of sexual assault.

3.06 Stages of Healing from Sexual Assault: Understands the multiple
stages of healing from sexual assault, and can facilitate the individualized
healing process for victims within the range of stages.

3.07 Referral Resources: Understands and utilizes the range of both
community and statewide systems of resources available to victims of
sexual assault and domestic violence.

4.01 Substance
Abuse: Understands and is able to identify substance abuse, its implications
and treatment options, and populations "at risk" for substance
abuse.

4.02 Substance Abuse and Domestic Violence: Distinguishes between the
two separate systems of substance abuse and battering, understands the
differences and parallels of the two systems, and understands and recognizes
the role and impact of substance abuse on domestic violence.

4.03 Women and Addiction: Understands and is able to identify dynamics
of working with women who are in recovery, whose abusive partner is
in recovery, or has been affected by substance abuse in some other way.

4.04 Mental Illness: Understands and is able to identify different types
of depression and mental illness and treatment resources.

4.05: Suicide: Understands the myths and realities of suicide, the role
of battering in suicide and attempted suicide, and suicide assessment
and intervention guidelines.

4.06 Mental Health, Addiction and Domestic Violence: Understands how
the intersections among addiction, mental illness and domestic violence
affect both victims of domestic violence and the ability to provide
services in the empowerment/self-help program models.

5.02 Protection from Abuse Order: Understands the purpose and composition
of a Protection from Abuse Order (PFA), and is able to assist abuse
victims with drafting and obtaining a PFA.

5.03 Criminal Proceedings: Understands the purpose of a criminal complaint
and prosecution, and is able to assist abuse victims with making a criminal
complaint, the steps of criminal prosecution, and the criminal system
requirements to pursue criminal relief.

5.04 Domestic Violence and the Courts: Understands the difference between
civil and criminal proceedings and victim's options within each, and
can instruct and support the victim in making appropriate choices, filing
a PFA, a criminal complaint, and Protection from Harassment orders.

5.06 Criminal Justice Services: Understands the roles of police, probation
officers, court personnel, including victim witness advocates, and prosecutors
as they impact the life of the abused woman; and understands bail conditions
as currently applied to misdemeanor and felony crimes.

5.07 Community Response Services: Understands and utilizes the range
of Community Response services available to victims and their children
and to communities working to eliminate domestic violence; the need
to determine for each individual victim what their appropriate response,
intervention, and assessment needs to be; and promotes effective community
response in their own community.

5.08 Systems Advocacy: Understands the definition of systems advocacy,
its philosophical basis, and the role of Community Response Services
in affecting systems change to end domestic violence.

6.01 Crisis
Intervention and Counseling: Understands and is able to utilize effective
crisis intervention and counseling skills, and identifies the goals
of counseling and the ethical and confidentiality issues involved in
domestic violence counseling.

6.02 Listening Skills and Women's Voices: Understands and utilizes effective
active listening skills, works through blocks to listening, and respects
and is directed by the "voices" of the women with whom you
are working.

6.03 Role of Advocates: Understands and is able to implement the principles
and practice of being an advocate for women's needs (individual and
collective) rather than a "case worker" for women and their
children.

6.04 Shelter Services: Understands and is able to provide the full complement
of shelter services available within the self-help, safe, and confidential
shelter program available.

6.06 Education and Support Group Services: Understands and is able to
assist victims in utilizing the full range of educational and support
group services available directly by the shelter or through referral
to other community services.

6.07 Individual Advocacy and Safety Planning: Understands the philosophical
and practical need for victims to develop advocacy skills for themselves
so that they can request and receive the services and protection needed
to live safely outside a domestic violence shelter.

6.08 Rural and Urban Differences: Understands, respects, and incorporates
the differing geographical, cultural, and safety issues which accompany
rural and city living and how the different environments affect the
type and format of services a community can provide to victims.

III. Substance Abuse

1.0 Definitions

1.01 Definitions
of Substance Abuse and Dependence: Understands definitions of substance
abuse and substance dependence and their corresponding levels of involvement.

1.02 Use-Abuse-Dependence Continuum: Understands and recognizes the
substance use continuum from use to unhealthy drinking to problem use
to substance abuse to dependence.

1.03 Signs and Symptoms: Understands and recognizes the dynamics and
indicators of substance problems.

1.04 DSM-IV Definitions of Abuse and Dependence: Understands the medical
definitions and implications of the DSM-IV categories of abuse and dependence
as differentiated from each other, including substance dependence with
physiological dependence and substance dependence without physiological
dependence.

2.02 Historical/Background Intake: Understands and utilizes necessary
intake techniques to develop an historical picture of the client, including
client's and family members' past and present substance use.

2.04 Client Education: Based on individual client's history and level
of involvement, is able to provide information, support and assistance
to client to understand her/his use/problem use/abuse/dependence.

3.0 Philosophical Approaches of Addiction

3.01 Disease
Model: Understands the theoretical frameworks and dynamics of the disease
model of understanding substance abuse or dependence.

3.02 Self-medication: Understands the dynamics of self-medication as
a conceptual model of understanding substance abuse or dependence.

3.03 Biopsychosocial Disorder: Understands the theoretical frameworks
and dynamics of biopsychosocial disorder as a model of understanding
substance abuse or dependence.

3.04 Rational Recovery: Understands the dynamics and use of the rational
recovery model of treatment for substance abuse or dependence.

3.05 Controlled or Low-Risk Drinking: Understands the dynamics and use
of a controlled or low-risk drinking model of treatment for substance
abuse or dependence without physiological dependence.

3.06 Spirituality: Understands the dynamics of spirituality as it intersects
with and provides a foundation for treatment models and 12-Step Programs.

3.07 12-Step Programs: Understands the steps and traditions of 12-Step
Programs as a self-help recovery model for substance abuse and dependence.

3.08 Diversity: Understands the dynamics and sensitivities of diversity
issues, such as cultural background, sexual orientation, etc., as they
affect and intersect with substance-related theory, conceptualizations,
and treatment and recovery models.

4.0 Change and Recovery Process

4.01 Interventions:
Has knowledge of and can implement therapeutic interventions when indicated
for a specific client.

4.02 Counseling: Understands and is able to utilize appropriate individual,
group, and/or family counseling modalities as a client may require.

4.03 Treatment Planning: Has ability to develop and implement a treatment
plan specific to a client's individual history, needs, and situation.

4.04 Treatment Referral: Understands and is able to refer clients to
appropriate resources when more intensive services are indicated for
a specific client.

5.0 Family Systems

5.01 Enabling:
Understands and is able to identify dynamics of enabling substance related
problems.

5.02 Parenting: Understands and is able to identify the dynamics and
relationship between problematic parenting and substance-related problems.

5.03 Family Violence: Understands and is able to identify the dynamics
of family violence as it affects, is affected by, and intersects with
substance-related problems.

5.04 Co-Affected: Understands and is able to identify the issues of
co-affected family members when substance-related problems affect the
family.

6.0 Human Development

6.01 Fetal
Alcohol Syndrome: Understands and is able to identify stages and processes
of fetal alcohol syndrome and its immediate and long term effects on
a fetus and child.

6.02 Fetal Alcohol Effects: Understands and is able to identify symptoms
of fetal alcohol effect and its developmental impact.

6.03 Pre-natal Substance-related Involvement: Understands and is able
to identify the symptoms and processes of substance-related problems
during pregnancy and the immediate and long-term effects for a prenatally
drug-exposed infant.

6.05 Adolescent Substance Abuse: Understands impact of substance use/abuse/addiction
on the specific developmental stages of adolescence as well as the cultural
influences upon adolescent use & abuse of substances.

6.06 Substance Abuse and Mental Illness: Understands and is able to
identify symptoms and dynamics of dual diagnosis and the need for collaborative
efforts for better therapeutic outcomes for this population.

7.0 Treatment Services, Referral Procedures, and Prevention Services

7.01 Resilience:
Understands and is able to utilize resilience-based concepts and strategies
that create, focus on, and promote positive environments and conditions
of health and well-being for individuals and families.

7.02 Relapse Prevention: Understands and utilizes relapse prevention
strategies that develop, support, and promote health and well-being
in family and community systems.

7.03 Risk and Protection Factors: Understands and utilizes risk and
protection factors for assuring safety and for prevention of substance-related
problems.

7.04 Prevention Strategies/Services: Has knowledge of, utilizes, and
makes referral to community based prevention programs and initiatives
whose focus is the prevention of substance-related problems.

7.05 Peer Groups/Self-Help: Has knowledge of and is able to access available
peer and self-help groups to which a client and co-affected persons
can be referred.

7.06 Professional Consultations: Has knowledge of and makes referral
to appropriate and/or registered/licensed substance abuse professionals
as indicated by the client's history, needs, and level of use/abuse/dependence.

7.07 Outpatient, Inpatient and Residential Facilities: Has knowledge
of and is able to access the services of community based outpatient
services and treatment programs, inpatient detox centers, residential
treatment centers, shelters, half-way houses, etc.

7.08 Record Keeping and Confidentiality: Understands the statutory restrictions
concerning case management, record keeping, confidentiality, and reporting
as reflected in federal and state laws governing substance-related treatment
information.

IV. Mental Health

1.0 Definitions

1.01 Definition
of Mental Illness: Has a basic understanding of the mental illness disorders
as listed within the DSM - IV.

1.02 Multiaxes: Has a basic understanding of the multiaxial assessment
systems used within the DSM - IV manual.

1.03 Diagnosis: Understands the major diagnostic codes used within the
DSM - IV manual.

1.04 Major Mental Health Disorders: Has a working knowledge and an understanding
of the major mental health disorders: anxiety, mood, psychotic, cognitive,
dissociate, eating and sleeping, adjustment and personality.

1.05 Signs and Symptoms: Understand and recognize the many signs, symptoms
and indicators associated with mental illness.

1.06 Mental Health Definition: Understand the definition of mental health,
within a continuum of mental health and health issues.

1.07 Dual Diagnosis: Understand and is able to identify symptoms and
dynamics of psychiatric comorbidity with substance abuse disorders.

3.02 Family Systems Model: Understand the theoretical framework and
dynamics of the family systems approach to mental health issues.

3.03 Cognitive and Behavioral Model: Has a working knowledge and understanding
of the cognitive and behavioral model approach to mental illness.

3.04 New Practice Models: Has an understanding of new approaches to
mental illness, for example the "story telling" model.

3.05 Spirituality: Understand the dynamics of spiritually issues as
it relates to the support of mental health issues.

3.06 Role-Modeling: Actively incorporates and demonstrates personal
and professional empowerment principles such as conflict management,
assertive communication, respect and acknowledgment of biases.

3.08 Medications: Has a working understanding and knowledge of the varied
medications provided to clients with mental health issues. Understanding
the issues associated with not taking medications, that not all issues
have an effective medication, issues associated with changing medications
and the impact of combining medications without adequate medical supervision.

4.0 Supporting Change

4.01 Interventions:
Has knowledge of and can use as appropriate a wide variety of intervention
strategies that support the client's efforts to grow and change.

4.02 Treatment Planning: Knows how to develop and implement a family-centered,
community driven treatment plan specifically developed for the clients
individuals strengths, needs and situation.

4.03 Counseling: Understands and is able to use appropriate informal
counseling techniques.

4.04 Advocacy: Understands the importance and has knowledge of the philosophical
needs for advocacy skill development with the client.

4.05 Multi-Dimensional: Understands the relationship among mental health
issues, substance abuse issues, educational issues, justice (public
safety) issues and how they interact to support the client and family
as well as pose the potential for conflict.

5.0 Community Services

5.01 Mental
Health Rights: Has an understanding and knowledge the rights of recipients
of mental health services within Maine's Public Laws.

5.02 Legal Supports: Understands and has a working knowledge of the
"class action" issues associated with mental health services
within Maine.

5.03 Community Based Supports and Services: Has a working knowledge
of the community based service agencies and supports available to assist
mental health clients and their families.

5.04 Residential - Out of Home Services: Has a working knowledge and
understanding of the residential and hospital based services available
to assist the clients and their family.

6.0 Values

6.01 Respect:
Regards people with significant mental health issues as persons with
dignity and competence, engaging then as full partners.

6.02 Inclusive: Includes family members and other community care providers
in all aspects of service planning.

6.03 On- going Evaluation: Understands the importance of constant evaluation
of the needs of the client, the strengths of the family and the appropriateness
of change.

6.04 Seeking Support: Understands the critical importance of obtaining
supportive supervision and consultation while working with mental health
clients.

6.04 Collaborative Community: Understands the principles of a collaborative
community, constantly working to improve and enhance the area's collaborative,
community-based system of care for the client.

6.05 Professionalism: Conducts all activities in a professional and
ethical manor.

Appendix:
Bibliography and Background Reading
Bernotavicz, Freda. "A New Paradigm for Competency-Based Training."
Journal of Continuing Social Work Education. Albany, NY: Continuing Education
Program, School of Social Welfare, State University of New York, 1994.

Bernotavicz, Freda. A Competency Model for Child Welfare Caseworkers.
Portland, ME: University of Southern Maine, Edmund S. Muskie School of
Public Affairs, 1994.

Knapp, et al. "Preparing Educators for Collaborative Practice: One
University's Contribution to the Integration of Education and Human Services."
Paper presented to University Council of Educational Administrators, Houston,
TX, November 1993.

Lawson, H. and K. Hooper-Briar. Expanding Partnerships: Involving Colleges
and Universities in Interprofessional Collaboration and Service Integration.
Oxford, OH: The Danforth Foundation and The Institute for Educational
Renewal at Miami University, 1994.

Wilson, James Q. What Government Agencies Do and Why They Do It. New York:
Basic Books, 1989.

Institute Of Public Sector Innovation

The University of Maine System Board of Trustees approved the Institute
for Public Sector Innovation (IPSI) as one of the three institutes that
make up the Research Programs of the Muskie School in January 1996.
IPSI grew out of two major collaborations with the Maine Department
of Human Services under the State/University Partnership agreement:
the Child Welfare Training Institute (CWTI) (established in 1989) and
the Department of Human Services Training Institute (DHSTI) (established
in 1992). These projects continue to be major components of the Institute,
along with expanded projects in collaboration with other state and federal
agencies such as the Departments of Mental Health, Mental Retardation
and Substance Abuse Services; Juvenile Justice and Corrections; Education;
and Maine's Judiciary. Institute activities now include areas such as:
strategic planning, organizational development, applied research, computer-based
technology, information systems, cross-system collaboration, and performance
management.

IPSI has a vision of competent and caring people in high performance
organizations creatively working together to promote the public good.
Recognizing the potential of people and organizations, IPSI serves the
public good by promoting individual and organizational effectiveness
and responsiveness in a climate of change. As a learning organization,
IPSI functions within a set of core competencies which include flexibility,
collaboration, independence, and commitment.

IPSI models and fosters a set of common values and action principles
built on six unifying themes including fostering self-responsibility,
striving for excellence, valuing diverse perspectives, systems thinking,
team learning, and modeling positive behavior.